Great Doctor. Completely helps you understand what issues you have and actually talks to you with great respect. – S.G.
Thank you very much. You are kind!- John McHugh
Great Doctor. Completely helps you understand what issues you have and actually talks to you with great respect. – S.G.
Thank you very much. You are kind!- John McHugh
This is a common question and maybe more common for me than other urologists. Why?
I make one mid-line opening using the no scalpel instrument. This is done at the peno-scrotal junction (upper aspect of the scrotum in the middle.) Through this opening the right side vas deferens is brought to the surface and the vasectomy is performed. This vas then returns to the right. Same thing is done on the left. (Many urologists make two openings, one on each side.)
What can be confusing to the patient is that days or weeks later he notes the mid-opening that is healed, but he feels a small knot on the left or right. What is going on? Something must be wrong.
The knot is where the body has begun the healing process. This varies from left to right, so that one patient may feel something on the right another the left. Because the opening is in the middle the assumption is that the swelling should be in the middle.
Now you know why it is left or right. The middle is where we access the left and right vas deferens but then it returns to its normal location and the healing process then begins.
If it is a small area and minimal discomfort, then this is the normal healing process and no need to call your doctor.
We offer vasectomy conscious sedation, fair all inclusive pricing for self pay patients and accept most all insurances. Call us when you’re ready to consider a vasectomy. We’ve done thousands.

Before the vasectomy patient can be released by the urologist to have unprotected sex, there must be two consecutive semen specimens with no sperm. It takes about 25 ejaculations to achieve this. We customarily give two specimen containers at the time of the vasectomy and recommend dropping off the specimens at approximately six and eight weeks. Dr. McHugh personally examines all of the specimens with a microscope.
After the initial clearance to proceed with unprotected sex, the chances of the the vasectomy “growing back together” is 1/2000.
In the diagram above you can see why. When Dr. McHugh performs a vasectomy a section of the vas is removed (red), both ends are cauterized (green) and then an absorbable suture (yellow) is placed on both ends as well.
The diagram above also answers another very common question about vasectomies: Does it affect the patient’s sex life?
The answer there is no. As you see, the only thing “tied off” is the vas deferens and this is where the sperm travels. Testosterone, which is responsible for the male’s sex drive, is produced in the testicle, but leaves the testicle in the blood stream not the vas deferens.
So there is a vas deferens between where the sperm exits and how the testosterone exits the testicle!
A vasectomy takes about 15 minutes and I do them through a single “size of a grain of rice” opening.
A reversal, in my hands, takes about two hours and more commonly uses two incisions (3/4 inch on each side of the upper scrotum over the course of the vas deferens) and requires an operating microscope and microscopic suture.
I tell patients that it is a minor procedure, minimal blood loss or other complications, but it does take two hours to do. Bruising and some scrotal swelling is more common and there is a longer recovery period.
So…to the question…same structure (the vas deferens) different procedure.
The interval of time from the vasectomy.
Studies have shown success is related to the timing of the vasectomy which in turn is related to the ability of the testicles to begin producing sperm again in adequate numbers to achieve pregnancy.
Click on “Success Rates” in Menu to see how the interval of the vasectomy affects success.
Well, yes. However, just because you can reverse a vasectomy, doesn’t mean that you will achieve pregnancy.
I have done several thousand vasectomies and several hundred microscopic vasectomy reversals, so…here are some things to consider “before” you decide to have a vasectomy.
So…you don’t want to have a vasectomy unless you are pretty darn sure you don’t want to have any more children. An option is to bank sperm before the vasectomy. This costs about $200 a year.
Conclusion: If you think there is any possibility that you might want to have more children do not have vasectomy. Depending on a reversal, even in the best scenario of surgeon and time interval from the vasectomy, is a risky endeavor.
On the flip side: If you have had a vasectomy, the chances of achieving pregnancy is essentially zero. In this setting having a reversal is very reasonable as any chance at pregnancy with a reversal is better than no chance. This is the reasoning most couples have when deciding to pursue a reversal.
First interesting thing: Getting an infection is uncommon. Most urologists do not place a suture in the small opening necessary for doing the procedure and this may be protective.
Second interesting thing: If there is a sperm granuloma or some swelling or tenderness under the scrotal skin, it usually resolves on its own and…is it almost always just on one side. In my experience it is rare to have an issue with both sides of the procedure. Each side is independent of the other. Go figure!
More questions? Go to the vasectomy page and read the eBook.